College of Engineering, Mathematics and Physical Sciences, University of Exeter, Exeter, UK
Somerset NHS Foundation Trust, Taunton, UK.
BMJ. 2021 Mar 9;372:n579. doi: 10.1136/bmj.n579.
To establish whether there is any change in mortality from infection with a new variant of SARS-CoV-2, designated a variant of concern (VOC-202012/1) in December 2020, compared with circulating SARS-CoV-2 variants.
Matched cohort study.
Community based (pillar 2) covid-19 testing centres in the UK using the TaqPath assay (a proxy measure of VOC-202012/1 infection).
54 906 matched pairs of participants who tested positive for SARS-CoV-2 in pillar 2 between 1 October 2020 and 29 January 2021, followed-up until 12 February 2021. Participants were matched on age, sex, ethnicity, index of multiple deprivation, lower tier local authority region, and sample date of positive specimens, and differed only by detectability of the spike protein gene using the TaqPath assay.
Death within 28 days of the first positive SARS-CoV-2 test result.
The mortality hazard ratio associated with infection with VOC-202012/1 compared with infection with previously circulating variants was 1.64 (95% confidence interval 1.32 to 2.04) in patients who tested positive for covid-19 in the community. In this comparatively low risk group, this represents an increase in deaths from 2.5 to 4.1 per 1000 detected cases.
The probability that the risk of mortality is increased by infection with VOC-202012/01 is high. If this finding is generalisable to other populations, infection with VOC-202012/1 has the potential to cause substantial additional mortality compared with previously circulating variants. Healthcare capacity planning and national and international control policies are all impacted by this finding, with increased mortality lending weight to the argument that further coordinated and stringent measures are justified to reduce deaths from SARS-CoV-2.
确定与 2020 年 12 月被指定为关注变异株（VOC-202012/1）的新型 SARS-CoV-2 变异株相比，感染该变异株的死亡率是否发生变化，该变异株于 2020 年 12 月流行。
配对队列研究。
英国社区（第 2 支柱）新冠病毒检测中心，使用 TaqPath 检测法（VOC-202012/1 感染的替代指标）。
2020 年 10 月 1 日至 2021 年 1 月 29 日期间，第 2 支柱中经 TaqPath 检测法检测呈 SARS-CoV-2 阳性的 54906 对匹配参与者，随访至 2021 年 2 月 12 日。参与者按照年龄、性别、种族、多重剥夺指数、低级别地方行政区和阳性样本的检测日期进行匹配，仅在 TaqPath 检测法检测刺突蛋白基因的可检测性上存在差异。
首次 SARS-CoV-2 检测阳性后 28 天内的死亡。
与感染之前流行的变异株相比，感染 VOC-202012/1 的患者感染社区获得性新冠病毒的死亡风险比为 1.64（95%置信区间 1.32 至 2.04）。在这个相对低风险的群体中，这意味着死亡人数从每 1000 例检出病例的 2.5 例增加到 4.1 例。
感染 VOC-202012/01 导致死亡率增加的可能性很高。如果这一发现具有普遍性，那么与之前流行的变异株相比，感染 VOC-202012/1 有可能导致大量额外死亡。医疗保健能力规划以及国家和国际控制政策都受到这一发现的影响，死亡率的增加使得进一步协调和严格的措施有理由减少 SARS-CoV-2 导致的死亡。
